This document discusses various methods for preventing dental caries. It describes topical protection measures like fissure sealants, fluoride varnish, and preventive resin restoration. Fissure sealants involve sealing pits and fissures with resin to make the surfaces non-retentive. Fluoride varnish is painted on teeth to allow remineralization and reduces smooth surface caries by 18-70%. Preventive resin restoration minimally removes decay and seals remaining pits and fissures. The document also discusses atraumatic restorative treatment, laser light applications, and systemic fluoride administration through water fluoridation or supplements to strengthen enamel and inhibit bacteria.
This document provides a history of fluorides and their discovery and use in dentistry. It discusses how fluorine was first discovered in the 18th century and early observations of fluorides in teeth and bones in the 19th century. In the early 20th century, Dr. McKay first observed mottled enamel in children in Colorado and suspected it was related to fluoride levels in drinking water. Extensive surveys and studies over decades by McKay, Black, Dean and others confirmed high fluoride levels in endemic areas with mottled enamel. They established fluoride's role in preventing dental caries when consumed in optimal levels in drinking water.
This document discusses fluorides in dentistry. It describes the sources of fluoride, mechanisms of how fluoride prevents tooth decay, and methods of fluoride delivery topically and systemically. It also addresses the indications for topical fluoride use, recommended dosages of fluoride tablets/drops, and potential toxicities like dental and skeletal fluorosis from inadequate or excessive fluoride intake. When used appropriately, fluoride is an effective cariostatic agent for improving dental health.
Early childhood caries (ECC) is a major public health problem affecting young children worldwide. ECC can develop soon after teeth erupt and involves colonization of the oral cavity by cariogenic bacteria like Streptococcus mutans. Clinical features include rapid progression of decay affecting maxillary anterior teeth first in a rampant pattern. Multiple factors contribute to ECC risk including prolonged bottle feeding with sugary liquids, genetic and socioeconomic factors. Management focuses on prevention through education and early intervention to arrest non-cavitated lesions.
The document discusses school health services and their objectives, which include appraising student health, counseling on findings, encouraging treatment, identifying disabilities, and providing emergency care. It also outlines components of school oral health programs like inspections, education, fluoride programs, sealant placement, and referrals. A specific program called Tattletooth that was implemented in Texas is described in detail, including its philosophy, implementation, and evaluation approach. The concepts of incremental and comprehensive dental care delivery models are also summarized.
Breastfeeding provides optimal nutrition for infants. Colostrum produced in the first few days after birth is higher in protein and electrolytes compared to mature breast milk produced after 3 weeks. Breast milk supports the infant's oral health by protecting against colonization of cariogenic bacteria and reducing the risk of early childhood caries, especially if nocturnal breastfeeding is avoided after teeth erupt. Diet counseling during infant oral health visits focuses on appropriate breastfeeding and weaning practices, use of bottles, and dietary fluoride supplementation based on water fluoride levels.
The document discusses dental caries prevention through various methods including chemical, nutritional, and mechanical approaches. It outlines primary, secondary, and tertiary levels of prevention and describes current prevention techniques such as fluoride application, dental sealants, and educating parents on infant oral healthcare. The overall goal of prevention is to limit bacterial growth and activity to prevent tooth decay from occurring or progressing.
This document discusses various methods of delivering fluorides, including topical and systemic fluorides. It focuses on topical fluoride delivery methods. Topical fluorides are divided into professionally-applied and self-applied products. Professionally-applied products include neutral sodium fluoride, acidulated phosphate fluoride, and stannous fluoride solutions. Self-applied products include fluoride dentifrices, gels, and rinses. The document provides details on the preparation, application procedures, mechanisms of action, advantages, and disadvantages of each topical fluoride product type. It recommends amounts and methods for safe and effective professional application of topical fluorides.
Fluoride reduces dental caries through multiple mechanisms including:
1) Incorporation into tooth enamel and dentin during development and after eruption, making the tooth structure less soluble in acid.
2) Interacting with the bacterial enzymes and metabolic processes that produce acid in dental plaque, reducing acid production.
3) Promoting remineralization of enamel and dentin that have been demineralized by acid from plaque bacteria.
This document provides a history of fluorides and their discovery and use in dentistry. It discusses how fluorine was first discovered in the 18th century and early observations of fluorides in teeth and bones in the 19th century. In the early 20th century, Dr. McKay first observed mottled enamel in children in Colorado and suspected it was related to fluoride levels in drinking water. Extensive surveys and studies over decades by McKay, Black, Dean and others confirmed high fluoride levels in endemic areas with mottled enamel. They established fluoride's role in preventing dental caries when consumed in optimal levels in drinking water.
This document discusses fluorides in dentistry. It describes the sources of fluoride, mechanisms of how fluoride prevents tooth decay, and methods of fluoride delivery topically and systemically. It also addresses the indications for topical fluoride use, recommended dosages of fluoride tablets/drops, and potential toxicities like dental and skeletal fluorosis from inadequate or excessive fluoride intake. When used appropriately, fluoride is an effective cariostatic agent for improving dental health.
Early childhood caries (ECC) is a major public health problem affecting young children worldwide. ECC can develop soon after teeth erupt and involves colonization of the oral cavity by cariogenic bacteria like Streptococcus mutans. Clinical features include rapid progression of decay affecting maxillary anterior teeth first in a rampant pattern. Multiple factors contribute to ECC risk including prolonged bottle feeding with sugary liquids, genetic and socioeconomic factors. Management focuses on prevention through education and early intervention to arrest non-cavitated lesions.
The document discusses school health services and their objectives, which include appraising student health, counseling on findings, encouraging treatment, identifying disabilities, and providing emergency care. It also outlines components of school oral health programs like inspections, education, fluoride programs, sealant placement, and referrals. A specific program called Tattletooth that was implemented in Texas is described in detail, including its philosophy, implementation, and evaluation approach. The concepts of incremental and comprehensive dental care delivery models are also summarized.
Breastfeeding provides optimal nutrition for infants. Colostrum produced in the first few days after birth is higher in protein and electrolytes compared to mature breast milk produced after 3 weeks. Breast milk supports the infant's oral health by protecting against colonization of cariogenic bacteria and reducing the risk of early childhood caries, especially if nocturnal breastfeeding is avoided after teeth erupt. Diet counseling during infant oral health visits focuses on appropriate breastfeeding and weaning practices, use of bottles, and dietary fluoride supplementation based on water fluoride levels.
The document discusses dental caries prevention through various methods including chemical, nutritional, and mechanical approaches. It outlines primary, secondary, and tertiary levels of prevention and describes current prevention techniques such as fluoride application, dental sealants, and educating parents on infant oral healthcare. The overall goal of prevention is to limit bacterial growth and activity to prevent tooth decay from occurring or progressing.
This document discusses various methods of delivering fluorides, including topical and systemic fluorides. It focuses on topical fluoride delivery methods. Topical fluorides are divided into professionally-applied and self-applied products. Professionally-applied products include neutral sodium fluoride, acidulated phosphate fluoride, and stannous fluoride solutions. Self-applied products include fluoride dentifrices, gels, and rinses. The document provides details on the preparation, application procedures, mechanisms of action, advantages, and disadvantages of each topical fluoride product type. It recommends amounts and methods for safe and effective professional application of topical fluorides.
Fluoride reduces dental caries through multiple mechanisms including:
1) Incorporation into tooth enamel and dentin during development and after eruption, making the tooth structure less soluble in acid.
2) Interacting with the bacterial enzymes and metabolic processes that produce acid in dental plaque, reducing acid production.
3) Promoting remineralization of enamel and dentin that have been demineralized by acid from plaque bacteria.
Space regaining involves moving a displaced permanent tooth into its proper position after premature loss of a deciduous tooth. Methods include fixed appliances like open coil springs and removable appliances like Hawley's retainers. Removable appliances are activated gradually over weeks to exert light distal force on molars and regain up to 2mm of space. Fixed appliances can regain space faster but require proper cementation. Space regaining is best done between ages 7-10 years when tooth roots are still developing.
The document defines a dental home as an ongoing relationship between a dentist and patient that provides comprehensive, accessible, and family-centered oral healthcare from infancy through adolescence. A dental home has characteristics like being accessible in the community, family-centered, providing unbiased information continuously, and being comprehensive, coordinated, and compassionate. When a parent or caregiver approaches a dental home, the dentist will take a history, do an examination, and do a risk assessment to enhance the dentist's ability to assist the child and family with optimal oral healthcare.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
This document discusses the history and uses of calcium hydroxide in pediatric dentistry. It describes how calcium hydroxide has been used since the early 20th century for its antibacterial properties and ability to induce hard tissue formation. The document outlines key developments in the understanding and application of calcium hydroxide, including its introduction as a root canal filling material in 1920 and subsequent uses in pulp capping, pulpotomy, apexification, and as an intracanal medicament. The history section covers improved formulations and vehicles for calcium hydroxide from the 1930s-1960s.
This document discusses dental pit and fissure sealants. It begins by defining pits and fissures, then provides a brief history of sealants. It describes the ideal requirements, materials used, indications and contraindications. It discusses which teeth should be sealed and the appropriate age ranges. The document concludes by outlining the technique for applying sealants.
This document provides information on band and loop space maintainers. It begins by introducing space maintainers and their objectives in maintaining arch integrity and guiding eruption of permanent teeth. It then discusses different types of space maintainers, including removable, fixed, functional and non-functional varieties. Specific appliances like band and loop, lingual arch, and distal shoe are explained. The document outlines the indications, contraindications, advantages and disadvantages of band and loop space maintainers. It provides details on the materials and instrumentation used in fabricating band and loop space maintainers. Overall, the document serves as an overview of band and loop space maintainers, their classification, objectives, considerations and fabrication.
This document discusses space maintainers, which are appliances used to maintain space for permanent teeth after premature loss of primary teeth. It describes different types of space maintainers including removable, fixed, lingual arch, and distal shoe appliances. Key factors in planning space maintenance like dental age and sequence of eruption are outlined. The document summarizes indications, contraindications, advantages and disadvantages of various space maintainer designs. Space maintainers aim to guide proper eruption of permanent teeth into ideal alignment and occlusion.
This document provides information on the ART (Atraumatic Restorative Treatment) procedure. It begins with an introduction stating that ART is a minimally invasive cavity preparation and restoration technique. The principles of ART are removing caries using only hand instruments and restoring the cavity with an adhesive material. Indications for ART include small, accessible cavities, while contraindications include exposed or inflamed pulps. Advantages include conserving tooth structure, reducing pain and trauma, and enabling the technique to be used in remote areas. The document describes the instruments, materials, procedures and concludes that ART focuses on providing dental care in developing countries.
Minimally invasive dentistry aims to control dental disease through early detection and least invasive treatment methods. It focuses on remineralizing early lesions and performing minimal surgical procedures. Recent advances include new cavity classification systems, preparation techniques like tunnels and slots, and caries removal methods like air abrasion, sonoabrasion, and chemomechanical removal. The Atraumatic Restorative Technique and Interim Therapeutic Restoration were developed to provide basic dental care using only hand instruments and restorative materials like glass ionomer cement. Lasers can also be used for caries prevention, removal and cavity preparation with minimal thermal damage to surrounding tooth structure.
School dental health programs aim to improve children's oral health through education, prevention, and treatment services directly in schools. The key aspects of such programs include conducting dental inspections and health education, providing preventive interventions like fluoride varnish and sealants, and making referrals for treatment when needed. Evaluations show such programs can reduce dental caries by 20-30% through approaches like water fluoridation, fluoride tablets, and toothbrushing programs in schools. The community benefits from improving children's oral health as it helps establish healthy habits that can last a lifetime.
This document provides an overview of professionally applied topical fluorides for caries prevention. It defines topical fluoride therapy as using high concentrations of fluoride applied locally to tooth surfaces. Common forms discussed include sodium fluoride, stannous fluoride, acidulated phosphate fluoride, and fluoride varnish. Application techniques and mechanisms of action are described for each. Effectiveness is supported by several clinical studies showing reductions in caries increment ranging from 30-66% with topical fluoride use. Contraindications and advantages/disadvantages of each product are also summarized.
Dental Fluorosis : double sided sword
Overview of this deadly disease in this presentation
Presented by: Shubham Shegokar
Guided by : Dr. Rehan Khan
Pediatric Dentitstry
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This presentation is all about the systemic administration of fluorides ,as it is an easier way for the administration of fluorides to prevent dental caries and tooth decay.the aim is to explain the advantages of systemic fluoride ,their present status in India and in other countries and to create awareness among population.Also raising an issue that how these methods of systemic fluoride administration can be improved so that there is better prevention of decay problems
Pulpotomy is the removal of the coronal portion of the pulp while preserving the radicular pulp. It is indicated for cariously exposed primary teeth when extraction is less advantageous than retention. There are various techniques for pulpotomy including devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using less harmful chemicals to maintain pulp vitality, and regeneration techniques aiming to stimulate reparative dentin formation. The goal of pulpotomy is to disinfect the exposed pulp, maintain pulp vitality, and avoid periapical issues.
This document discusses the historical evolution and use of fluorides for dental caries prevention. It begins with early discoveries of fluoride in enamel in 1805 and the isolation of fluorine as an element in 1771. It then covers fluoride chemistry, sources of fluoride intake from water, food, beverages and air. The document discusses fluoride metabolism, distribution in tissues, and excretion. It also addresses water fluoridation, which began in 1945 in Grand Rapids, USA and defines water fluoridation as the controlled adjustment of fluoride in communal water to maximize caries prevention with minimal fluorosis risk.
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
The Tattletooth Program is a school-based dental health program developed in Texas in the 1970s. It aims to develop knowledge and skills around preventing dental disease in schoolchildren. The program provides self-contained teaching packets for classroom teachers to educate students on dental health facts across 5 different age-appropriate levels, from preschool to high school. Lesson plans, materials, and strategies for parental involvement are included. The program piloted an approach of classroom dental health education to promote prevention.
Fluoride is: natural mineral that helps build strong teeth and prevent cavities
Fluoride treatment; is typically professional treatment containing high concentration of fluoride that dentist or hygienist will apply to a person’s teeth to improve health and reduce the risk of cavities
Benefits of fluoride treatment:
1- Slow or reverse the development of cavities by harming bacteria that cause cavities.
2- Join into tooth structure when tooth develop to strengthen the enamel surface
3- Helps body, better use mineral such as Ca and phosphate, the teeth reabsorb these mineral to repair weak tooth enamel
Side effect of fluoride:
1- Tooth discoloration
2- Allergies or irritation
3- Toxic effect: if person apply it incorrectly or at high doses: nausea, diarrhea, excessive sweating
Common source of dietary fluoride:
Tea, water, sea food, fish eaten with their bones
Grape juice, food cooked in water.
Optimal fluoride intake:
Birth to 3 years: ---- 0.1 to 1.5 mg
4 years of age: ------1 to 2,5mg
7 years of age: ------ 1.5 to 2.5mg
Adolescent and adult: --- 1.5 to 4mg
History:
1802: Sir James Crichton Browne, the 1st hint of possible connection of fluoride and dental health
1901: Fredrek Mckay: present in permanent stains on teeth known as mottled enamel
1902: J.M Eager: stains on teeth
1916: Green Vardmin Black: support the Mckay work with histologic evidence, reported as endemic imperfection of enamel
Fluoride application procedures:
1- Fluoride prophylaxis pastes:
The use of cleaning and polishing pastes (pumic, zircate) and other comparable abrasive pastes before cementing orthodontic bands may lead to removal of significant amount of surface enamel which has more resistant layer and provide a significant amount of fluoride to support enamel surface.
2- Topical fluoride solution:
The most commonly used topical solutions are;
Sodium fluoride –2% neutral
Acidulated sodium fluoride at PH3 and 1.2 fluoride
8% --10% stannous fluoride.
3- Fluoride gel:
Are available in; sodium fluoride, acidulated sodium fluoride, stannous fluoride
4- Fluoride mouth rinse
5- Fluoride tablets:
Fluoride administration as pills or tablets (0.5 ---1mg/day) according to age show caries reduction in permanent teeth of 20 --- 40% when started at 6 –9 years of age
6- Fluoride dentifrices:
There are large number of dentifrices in market as, sodium fluoride, stannous fluoride, amine fluoride
Sodium monofluorophosphate
The regular use of fluoride dentifrices should be recommended to all patients undergoing orthodontic treatment in addition to other forms of fluoride administration
7- Fluoride cements:
Silicate cements restoration slowly release fluorides and protect surrounding enamel from secondary caries
8- Fluoride varnish:
Topical application of fluoride predisposes to the formation of readily soluble Ca fluoride crystals on the enamel surface
9- Other methods: as elastic containing 10% sodium fluoride.
Some studies:
1- Good oral hygiene was the only
This document provides information on the prevention of dental caries through the use of fluoride. It discusses that fluoride can be used systemically by ingesting it or topically by direct application. Fluoride works to prevent dental caries by strengthening enamel, inhibiting bacteria, and enhancing remineralization. Sources of fluoride include water, foods, dental products, and professional treatments. Both optimal levels and methods of delivery are covered.
Space regaining involves moving a displaced permanent tooth into its proper position after premature loss of a deciduous tooth. Methods include fixed appliances like open coil springs and removable appliances like Hawley's retainers. Removable appliances are activated gradually over weeks to exert light distal force on molars and regain up to 2mm of space. Fixed appliances can regain space faster but require proper cementation. Space regaining is best done between ages 7-10 years when tooth roots are still developing.
The document defines a dental home as an ongoing relationship between a dentist and patient that provides comprehensive, accessible, and family-centered oral healthcare from infancy through adolescence. A dental home has characteristics like being accessible in the community, family-centered, providing unbiased information continuously, and being comprehensive, coordinated, and compassionate. When a parent or caregiver approaches a dental home, the dentist will take a history, do an examination, and do a risk assessment to enhance the dentist's ability to assist the child and family with optimal oral healthcare.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
This document discusses the history and uses of calcium hydroxide in pediatric dentistry. It describes how calcium hydroxide has been used since the early 20th century for its antibacterial properties and ability to induce hard tissue formation. The document outlines key developments in the understanding and application of calcium hydroxide, including its introduction as a root canal filling material in 1920 and subsequent uses in pulp capping, pulpotomy, apexification, and as an intracanal medicament. The history section covers improved formulations and vehicles for calcium hydroxide from the 1930s-1960s.
This document discusses dental pit and fissure sealants. It begins by defining pits and fissures, then provides a brief history of sealants. It describes the ideal requirements, materials used, indications and contraindications. It discusses which teeth should be sealed and the appropriate age ranges. The document concludes by outlining the technique for applying sealants.
This document provides information on band and loop space maintainers. It begins by introducing space maintainers and their objectives in maintaining arch integrity and guiding eruption of permanent teeth. It then discusses different types of space maintainers, including removable, fixed, functional and non-functional varieties. Specific appliances like band and loop, lingual arch, and distal shoe are explained. The document outlines the indications, contraindications, advantages and disadvantages of band and loop space maintainers. It provides details on the materials and instrumentation used in fabricating band and loop space maintainers. Overall, the document serves as an overview of band and loop space maintainers, their classification, objectives, considerations and fabrication.
This document discusses space maintainers, which are appliances used to maintain space for permanent teeth after premature loss of primary teeth. It describes different types of space maintainers including removable, fixed, lingual arch, and distal shoe appliances. Key factors in planning space maintenance like dental age and sequence of eruption are outlined. The document summarizes indications, contraindications, advantages and disadvantages of various space maintainer designs. Space maintainers aim to guide proper eruption of permanent teeth into ideal alignment and occlusion.
This document provides information on the ART (Atraumatic Restorative Treatment) procedure. It begins with an introduction stating that ART is a minimally invasive cavity preparation and restoration technique. The principles of ART are removing caries using only hand instruments and restoring the cavity with an adhesive material. Indications for ART include small, accessible cavities, while contraindications include exposed or inflamed pulps. Advantages include conserving tooth structure, reducing pain and trauma, and enabling the technique to be used in remote areas. The document describes the instruments, materials, procedures and concludes that ART focuses on providing dental care in developing countries.
Minimally invasive dentistry aims to control dental disease through early detection and least invasive treatment methods. It focuses on remineralizing early lesions and performing minimal surgical procedures. Recent advances include new cavity classification systems, preparation techniques like tunnels and slots, and caries removal methods like air abrasion, sonoabrasion, and chemomechanical removal. The Atraumatic Restorative Technique and Interim Therapeutic Restoration were developed to provide basic dental care using only hand instruments and restorative materials like glass ionomer cement. Lasers can also be used for caries prevention, removal and cavity preparation with minimal thermal damage to surrounding tooth structure.
School dental health programs aim to improve children's oral health through education, prevention, and treatment services directly in schools. The key aspects of such programs include conducting dental inspections and health education, providing preventive interventions like fluoride varnish and sealants, and making referrals for treatment when needed. Evaluations show such programs can reduce dental caries by 20-30% through approaches like water fluoridation, fluoride tablets, and toothbrushing programs in schools. The community benefits from improving children's oral health as it helps establish healthy habits that can last a lifetime.
This document provides an overview of professionally applied topical fluorides for caries prevention. It defines topical fluoride therapy as using high concentrations of fluoride applied locally to tooth surfaces. Common forms discussed include sodium fluoride, stannous fluoride, acidulated phosphate fluoride, and fluoride varnish. Application techniques and mechanisms of action are described for each. Effectiveness is supported by several clinical studies showing reductions in caries increment ranging from 30-66% with topical fluoride use. Contraindications and advantages/disadvantages of each product are also summarized.
Dental Fluorosis : double sided sword
Overview of this deadly disease in this presentation
Presented by: Shubham Shegokar
Guided by : Dr. Rehan Khan
Pediatric Dentitstry
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This presentation is all about the systemic administration of fluorides ,as it is an easier way for the administration of fluorides to prevent dental caries and tooth decay.the aim is to explain the advantages of systemic fluoride ,their present status in India and in other countries and to create awareness among population.Also raising an issue that how these methods of systemic fluoride administration can be improved so that there is better prevention of decay problems
Pulpotomy is the removal of the coronal portion of the pulp while preserving the radicular pulp. It is indicated for cariously exposed primary teeth when extraction is less advantageous than retention. There are various techniques for pulpotomy including devitalization with formocresol or other chemicals to fix the pulp, preservation techniques using less harmful chemicals to maintain pulp vitality, and regeneration techniques aiming to stimulate reparative dentin formation. The goal of pulpotomy is to disinfect the exposed pulp, maintain pulp vitality, and avoid periapical issues.
This document discusses the historical evolution and use of fluorides for dental caries prevention. It begins with early discoveries of fluoride in enamel in 1805 and the isolation of fluorine as an element in 1771. It then covers fluoride chemistry, sources of fluoride intake from water, food, beverages and air. The document discusses fluoride metabolism, distribution in tissues, and excretion. It also addresses water fluoridation, which began in 1945 in Grand Rapids, USA and defines water fluoridation as the controlled adjustment of fluoride in communal water to maximize caries prevention with minimal fluorosis risk.
This document discusses apexification and indirect pulp capping procedures. Apexification is used to induce calcification at the open apex of an immature tooth to allow for root canal treatment. Materials used include calcium hydroxide, tricalcium phosphate, and MTA. Calcium hydroxide is placed in the canal and replaced every 3 months until radiographic evidence of apical barrier formation. MTA can also be used by placing it at the apex. Indirect pulp capping covers the deepest carious dentin with a biocompatible material like calcium hydroxide to prevent pulpal exposure while removing infected dentin, allowing for pulp preservation.
The Tattletooth Program is a school-based dental health program developed in Texas in the 1970s. It aims to develop knowledge and skills around preventing dental disease in schoolchildren. The program provides self-contained teaching packets for classroom teachers to educate students on dental health facts across 5 different age-appropriate levels, from preschool to high school. Lesson plans, materials, and strategies for parental involvement are included. The program piloted an approach of classroom dental health education to promote prevention.
Fluoride is: natural mineral that helps build strong teeth and prevent cavities
Fluoride treatment; is typically professional treatment containing high concentration of fluoride that dentist or hygienist will apply to a person’s teeth to improve health and reduce the risk of cavities
Benefits of fluoride treatment:
1- Slow or reverse the development of cavities by harming bacteria that cause cavities.
2- Join into tooth structure when tooth develop to strengthen the enamel surface
3- Helps body, better use mineral such as Ca and phosphate, the teeth reabsorb these mineral to repair weak tooth enamel
Side effect of fluoride:
1- Tooth discoloration
2- Allergies or irritation
3- Toxic effect: if person apply it incorrectly or at high doses: nausea, diarrhea, excessive sweating
Common source of dietary fluoride:
Tea, water, sea food, fish eaten with their bones
Grape juice, food cooked in water.
Optimal fluoride intake:
Birth to 3 years: ---- 0.1 to 1.5 mg
4 years of age: ------1 to 2,5mg
7 years of age: ------ 1.5 to 2.5mg
Adolescent and adult: --- 1.5 to 4mg
History:
1802: Sir James Crichton Browne, the 1st hint of possible connection of fluoride and dental health
1901: Fredrek Mckay: present in permanent stains on teeth known as mottled enamel
1902: J.M Eager: stains on teeth
1916: Green Vardmin Black: support the Mckay work with histologic evidence, reported as endemic imperfection of enamel
Fluoride application procedures:
1- Fluoride prophylaxis pastes:
The use of cleaning and polishing pastes (pumic, zircate) and other comparable abrasive pastes before cementing orthodontic bands may lead to removal of significant amount of surface enamel which has more resistant layer and provide a significant amount of fluoride to support enamel surface.
2- Topical fluoride solution:
The most commonly used topical solutions are;
Sodium fluoride –2% neutral
Acidulated sodium fluoride at PH3 and 1.2 fluoride
8% --10% stannous fluoride.
3- Fluoride gel:
Are available in; sodium fluoride, acidulated sodium fluoride, stannous fluoride
4- Fluoride mouth rinse
5- Fluoride tablets:
Fluoride administration as pills or tablets (0.5 ---1mg/day) according to age show caries reduction in permanent teeth of 20 --- 40% when started at 6 –9 years of age
6- Fluoride dentifrices:
There are large number of dentifrices in market as, sodium fluoride, stannous fluoride, amine fluoride
Sodium monofluorophosphate
The regular use of fluoride dentifrices should be recommended to all patients undergoing orthodontic treatment in addition to other forms of fluoride administration
7- Fluoride cements:
Silicate cements restoration slowly release fluorides and protect surrounding enamel from secondary caries
8- Fluoride varnish:
Topical application of fluoride predisposes to the formation of readily soluble Ca fluoride crystals on the enamel surface
9- Other methods: as elastic containing 10% sodium fluoride.
Some studies:
1- Good oral hygiene was the only
This document provides information on the prevention of dental caries through the use of fluoride. It discusses that fluoride can be used systemically by ingesting it or topically by direct application. Fluoride works to prevent dental caries by strengthening enamel, inhibiting bacteria, and enhancing remineralization. Sources of fluoride include water, foods, dental products, and professional treatments. Both optimal levels and methods of delivery are covered.
This document discusses fluorides and their role in preventing dental caries. It begins with a brief history of fluoride research from the early 20th century and describes how fluoride strengthens tooth enamel and inhibits the cariogenic bacteria. It then discusses various methods of fluoride administration including water fluoridation, salt fluoridation, milk fluoridation and topical fluoride applications. Water fluoridation at 0.7-1.2 ppm is described as the most effective method for community-wide caries prevention, while topical fluorides provide localized protection when applied directly to the teeth. The document outlines the metabolism, mechanisms of action, and non-dental benefits of systemic fluoride intake.
learning objectives
Introduction
History Of Water Fluoridation
How Does Fluoride Act In Dental Caries Prevention?
Goals Of F Administration
Fluoride Administration
Appropriate Levels Of Fluoride in Drinking Water
Methods of water fluoridation
--------------------------------------------------------------------
Efficacy Of topical fluorides
Range Of therapeutic fluoride concentrations used to prevent caries
Recommended doses
Fluoride is a trace element found naturally in water sources and soils. It is beneficial for dental health when consumed in optimal amounts. Fluoride strengthens tooth enamel and promotes remineralization. It is most effectively delivered through community water fluoridation but can also be obtained through foods, supplements, and topical treatments like toothpaste. Both low and high fluoride intake can pose health risks like dental fluorosis. Careful monitoring of intake levels is important, especially for young children, to maximize dental benefits and avoid risks.
The document discusses fluorides used in operative dentistry. It provides a history of fluoride research and use, starting from discoveries of fluorosis in the early 1900s to modern community water fluoridation programs. It also details various fluoride delivery systems including topical and systemic methods. Topical methods such as sodium fluoride, acidulated phosphate fluoride, stannous fluoride, and fluoride varnishes are described along with their mechanisms and application techniques. The document discusses the anticaries effects and recommendations for use of these fluorides.
This document discusses various methods of fluoride delivery for dental caries prevention. It describes topical fluoride delivery methods including toothpastes, mouthwashes, varnishes and professionally applied gels and foams. It also discusses systemic fluoride delivery through community water fluoridation, salt fluoridation, milk fluoridation and fluoride tablets. The document outlines the advantages and disadvantages of different fluoride compounds and delivery methods. It also discusses the potential toxicity of excessive fluoride intake and prevalence of dental fluorosis in India.
This document discusses fluoride and its role in preventing dental caries. Fluoride occurs naturally and is also added to products like toothpaste, water supplies, and topical treatments. It helps strengthen enamel, increases remineralization, and decreases demineralization. Too much fluoride can cause fluorosis, but using fluoride appropriately from sources like toothpaste can reduce tooth decay by 20-35%. Professional treatments include varnishes and gels that are more effective but used less frequently.
Fluoride is effective at preventing dental caries through several mechanisms: it reduces demineralization by lowering bacterial acid production and enamel solubility; increases remineralization of incipient lesions; and interferes with plaque microorganisms. Topical fluoride treatments delivered professionally as gels, foams, varnishes or professionally-applied solutions provide a localized source of fluoride to tooth surfaces, while systemic fluoride from water or supplements provides lower levels of fluoride incorporated into developing teeth and bone.
Fluoride is a mineral found in nature that helps prevent cavities. It is present in small amounts in foods and drinks, and in higher amounts in seafood and tea leaves. The main sources of fluoride are drinking water, toothpaste, and professionally applied gels, foams, and rinses. Fluoride strengthens tooth enamel, enhances remineralization, alters the activity of plaque bacteria, and helps develop strong teeth. It can be delivered topically through products like toothpaste or professionally through gels, foams, varnishes, and rinses.
The document discusses several theories on how fluoride reduces dental caries. The pre-eruptive theory states that fluoride taken during tooth formation can change tooth composition and morphology by replacing hydroxyl groups in tooth enamel with fluoride. The post-eruptive theory explains that fluoride in saliva and plaque reacts with tooth enamel to enhance remineralization and form calcium fluoride or fluorapatite crystals. Topically applied fluoride at high concentrations can also interfere with bacterial growth and metabolism. Fluoride reduces caries by increasing enamel resistance, promoting remineralization of early lesions, and interfering with cariogenic plaque bacteria.
This document discusses a preventive dentistry program focused on fluoride and fissure sealants presented by Heidi Emmerling. It covers the goals of fluoride administration, recommended fluoride levels in water, potential toxicity of fluoride ingestion, emergency treatment, topical fluoride applications, and fissure sealant indications and limitations. The goals are to prevent decay, arrest active decay, and remineralize teeth using optimal fluoride levels tailored to climate. Potential fluoride toxicity and treatments are also outlined.
This document provides information about fluorine and its compounds. It discusses the properties of hydrogen fluoride, sodium fluoride, and fluorosilicic acid. It describes the major uses of inorganic fluorine compounds in industry and for municipal water fluoridation. The document also discusses how fluoride prevents dental caries by enhancing remineralization and inhibiting demineralization of tooth enamel. It provides facts about water fluoridation in the United States.
Topical fluoride is applied directly to the teeth to help prevent cavities. There are many forms of topical fluoride including solutions like sodium fluoride and stannous fluoride, gels, varnishes, and toothpastes. They work by being incorporated into tooth enamel to form calcium fluoride or fluorapatite, making the enamel more resistant to demineralization. The appropriate method depends on factors like a patient's risk of cavities and age. When used as recommended, topical fluorides are very effective at caries prevention.
The document discusses fluoride in preventive dentistry. It provides information on the following:
- Fluoride content in the environment including soil, water, and atmosphere.
- Types of systemic and topical fluoride therapies including water fluoridation, supplements, and professionally-applied varnishes, gels, and foams.
- Details on commonly used topical fluoride agents like sodium fluoride, stannous fluoride, acidulated phosphate fluoride, and fluoride varnishes.
Dental fluorosis is caused by excessive fluoride intake during tooth development and results in changes to enamel formation. It ranges from mild opaque white markings to brown stains and porous enamel. Prevention involves limiting fluoride from sources like water, toothpaste and supplements during ages 6-8 when teeth are developing. Treatment depends on severity and may include bleaching, microabrasion, composites, veneers or crowns.
This document provides an overview of fluorides in dentistry. It discusses the chemistry and sources of fluoride, including water, food, air and consumer products. It describes the metabolism and distribution of fluoride in the body, including deposition in bones and teeth. The historical evidence supporting the role of fluoride in preventing dental caries is presented. The mechanisms of action are explained, such as fluoride incorporation into dental tissues and its cariostatic effects. Methods of delivering fluoride to the population to prevent tooth decay are covered, including water fluoridation and professionally or self-applied topical fluorides. Potential toxicity at high levels is also mentioned.
1) Fluoride is effective in preventing dental caries through several mechanisms including increasing enamel resistance, enhancing remineralization, and interfering with plaque microorganisms.
2) Fluoride can be incorporated into developing enamel through ingestion, making teeth more resistant to decay. It also topically enhances the remineralization of enamel.
3) Both acute and chronic fluoride toxicity can occur. Acute toxicity results from short-term high intake and can cause gastrointestinal, neurological, and cardiac issues. Chronic toxicity like dental fluorosis and skeletal fluorosis occurs from long-term low intake.
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Lecture 3 Facial cosmetic surgery
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https://twitter.com/lama_k_banna
Lecture 1 Facial cosmetic surgery
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https://twitter.com/lama_k_banna
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https://twitter.com/lama_k_banna
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Lecture 12 general considerations in treatment of tmdLama K Banna
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Lecture Name 12 general considerations in the treatment of TMJ
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https://twitter.com/lama_k_banna
Lecture 11 temporomandibular joint Part 3Lama K Banna
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Al Azhar University Gaza Palestine
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The document discusses epidemiological studies that estimate the prevalence of malocclusion and dentofacial deformities in the United States population. The National Health and Nutrition Examination Survey found that approximately 2% of the US population has severe mandibular deficiency or vertical maxillary excess, while other abnormalities such as mandibular excess or open bite affect about 0.3-0.1% of the population. Overall, about 2.7% of Americans may have dentofacial deformities severe enough to require surgical treatment along with orthodontics.
lecture 4 Diagnosis and management of salivary gland disordersLama K Banna
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This document discusses principles of managing panfacial fractures, including anatomic considerations of the craniofacial skeleton and buttresses. It describes two main theories for management: bottom up/inside out and top down/outside in. Reduction, fixation, immobilization and early return of function are discussed. Closed reduction uses manipulation without visualization, while open reduction allows visualization but requires surgery. Various fixation methods are outlined, including arch bars, wiring techniques, and maxillomandibular fixation.
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3. This includes all measures applied to increase the
resistance of the intact outer tooth surface.
Among these measures are operative dentistry,
prophylactic odontotomy, prophylactic fissure filling,
topical chemotherapy, fissure sealants, preventive resin
restoration and atraumatic dentistry (ART) are the most
essential.
5. 1- Fissure sealants:
Fissure sealants are materials used to (correct) seal
deep pits and fissures and change them into non-
retentive surfaces. There is considerable evidence
that a significant caries reduction observed when
fissure sealants are correctly applied to deep pits
and fissures of newly erupted teeth.
6. Types of sealant materials:
Nowadays several materials are commercially
available. These are either chemically cure or light
cure (using visible light). These are:
1. BIS- GMA resin (filled or unfilled).
2. Glass ionomer cement.
3. Compo mer.
7. Application of pit and fissure sealants:
It should be noted that newly erupted posterior teeth with
deep pits and fissures are the suitable teeth for application.
8. Steps of application are:
1. Remove any debris using pumice slurry on small brush or
prophylactic rubber cup.
2. Wash the tooth with air water spray.
3. Isolate the tooth with cotton rolls and use saliva ejector.
4. Dry the tooth with compressed air.
5. Etch the occlusal tooth surface with enamel etching solution
or gel (37% ortho-phosphoric acid) for one minute.
6. Wash thoroughly with air water spray.
9. Steps of application are:
7. Dry with compressed air until chalky white enamel
surface appears.
8. Apply the fissure sealant with little brush.
9. Polymerize light cure sealant for 20 seconds keeping the tip
of the light gun as close to the surface as possible.
10. Check the height (high spots) of the polymerized material
and correct with fine stone when possible.
11. Check the success of sealant application at 6 monthly
period .
10.
11.
12. 2- Fluoride Varnish:
It is a sticky yellowish protective coating in a resin base that
is painted over the teeth surface in an attempt to prevent
dental caries or to allow remineralization of initially
demineralized enamel surfaces.
Studies showed about 18-70% reduction of smooth surface
caries.
14. It has the ability to adhere to enamel for long periods and
thus release fluoride slowly to the teeth.
The commercially available varnishes contain either 5%
Sodium fluoride or 1 % Fluorosilane.
It is applied by brush and allowed to harden for 5-6 minutes.
The application should be repeated at 3-6 months interval.
15. 3- Preventive resin restoration:
This procedure was born of fissure sealant.
The technique is based upon restoring minimal carious lesion
usually in young permanent molars with minimum removal of
tooth structures, while concomitantly preventing caries from
attacking other pits and fissures on the same surface without
mechanically removal of these areas.
16. Technique:
A small round bur may be used for access and removal any
carious tissue.
The tooth is then etched as for sealant application, and a pit
and fissure sealant is applied.
A composite of thin consistency may be used.
17. 4- Atraumatic restorative treatment (ART):
The two main principle of ART are:
1. Removing carious tooth tissue using hand
instruments only.
2. Restoring the cavity with adhesive filling
material currently as glass ionomer.
18. Carious cavities suitable for ART should be:
A. Involving the dentin with no pulpal involvement.
B. Accessible to hand instruments.
19. The advantages of ART include:
1. Use of easily available and inexpensive procedure to
conserve sound tooth surfaces.
2. Permit oral health care workers to reach people who
otherwise never would have received any oral care; such
as handicapped, villages in rural and suburban areas,
homebound, institutionalized people and economically less
developed countries.
21. Laser Light in preventive dentistry:
Recently, laser has been introduced for use in dentistry
.Different approaches has been thought to be promising in
caries prevention for:
1. Increasing the resistance of dental tissues to caries by
reducing the rate of demineralization.
2. Sealing pits and fissures and homogenizes the enamel
surface by melting structural elements.
22. Laser Light in preventive dentistry:
3. Laser application encourages fluoride uptake by dental
tissues.
4. Laser application to carious lesions vaporizes enamel caries
and adjacent sound enamel fuses and eliminates small
defects.
5. Application of laser prior to application of fissure sealants
improves its retention.
23. The only topical method with
real effect in caries control is the
topical application of fluoride in
one way or the other.
25. What is fluoride?
It is one of the halogens.
It is the most active element of this group. It is not present in
the free form.
Fluoride is the combined form of the free element. It is
difficult to obtain a sample of calcium compound from a
natural source in a completely fluoride free condition.
It is present in soil, seawater, rainwater, seafood, etc.
Fluoride is the only proved diet substance to be of
anticariogenic benefit for humans.
26. Fluoride can be used to control dental caries either by:
1. Systemic route, i.e. by ingesting fluoride.
2. Topical application.
27. Mode of Action of Fluoride:
The role played by fluoride in the control of dental
canes is mainly as
follows:
28. 1. Ionic exchange of fluoride with the hydroxyl group of
calcium hydroxyapetite in the surface layers of enamel
changing it into fluoroapetite, which is less soluble in acids.
2. Enzymatic inhibition interfering with the breakdown of
glucose to lactic and pyruvic acid. Both phosphatase and
anulase enzymes are inhibited by fluoride.
3. Bacterial inhibition, fluoride has a direct inhibitory effect
on the bacteria of the dental plaque.
4. Fluoride has the ability to precipitate minerals from saturated
solutions.
As saliva is saturated by minerals, fluoride favors the
precipitation of the __ calcium phosphate on the surface of
enamel, so it aids in remineralization of partially
demineralized enamel in early caries.
29. 5. Fluoride lowers free surface energy. This will decrease the
plaque accumulation on the treated enamel surface.
6. Action on tooth size and morphology: In communities with
fluoridated water supply, there is a trend towards shallower
fissures and lower cusp height and smaller tooth size. This
will decrease caries susceptibility
30. Sources of Fluoride:
Humans obtained fluoride three sources: water, foods and air.
Two of them, water and food, may contribute significant
amounts to the daily intake.
Water from deep wells and artesian wells usually provide high
natural fluoride concentration.
Most vegetables, fruits and dairy products contain low amount
of fluoride.
Meat also contain little fluoride but seafoods (fish sp. salmon
and sardines, shrimp, crab, etc) may contain 2.5 ppm.
Most beverages contain amounts of fluoride especially tea.
31. Fruit juices and soft drinks are generally low in fluoride, but
the fluoride content of the water used in the preparation of
such beverages or in the cooking of food will be reflected in
the fluoride concentration of the final product.
The total amount of fluoride consumed daily will depend
upon both the concentration of the fluoride in the water and
food as well as the amount consumed.
The recommended optimal fluoride doses for community
water supplies vary with the annual mean of the maximum
daily temperature (0.7 to 1.2 ppm).
The average diet provides 0.2-0.3 mg of fluoride daily.
32. Fluoride Content of Enamel:
Tooth enamel is composed mainly of hydroxyapatite and a little
proportion of calcium carbonate Traces from other elements
present either incorporated in the structure of the crystals or
concentrated on the enamel surface.
It was noticed that there is an inverse relationship between
fluoride and carbonate concentrations in enamel.
Fluoride is concentrated at the surface and decreases towards the
amelodentinal junction.
Its concentration in surface enamel reaches 2000-3000 ppm in
water-fluoridated areas.
33. Uptake of Fluoride by the Teeth:
Fluoride is incorporated in enamel and dentine in two stages:
Before eruption:
During Calcification, traces of fluoride incorporated into the
crystalline structure of appetite lattice. Further amounts of fluoride
are taken up by the external enamel surface from the surrounding
tissue fluids before eruption.
After eruption:
Enamel surface continues to pick up fluoride derived from diet,
water and saliva. The post-eruptive acquisition of fluoride continues
throughout life and is directly proportional to the concentration in
food and water ingested.
34. Toxicity of Fluoride:
High doses of fluoride are toxic and may be lethal
Fortunately, this is rare and only few accidental cases are
reported.
The severity depends upon the amount ingested and the
duration of intake.
Chronic fluorosis results in skeletal or dental changes.
Mottled enamel may result with various degrees of severity
when water fluoride concentration is (6-8 ppm).
Later in life, the ingestion of high levels of fluoride may result
in bony deformities joint fixation and calcification of the
ligaments.
35. Methods of Providing Fluoride:
This can be achieved either by ingesting calculated amount
of fluoride to be incorporated in the developing teeth, or
topically applying fluoride preparations on exposed tooth
surfaces to increase their resistance to cariogenic processes.
37. 1. Water fluoridation:
There is an inverse relationship between the fluoride level in
drinking water supplies and the incidence of dental caries.
There is also a direct relationship between fluoride level and
the number of caries free individuals in the community. This
beneficial effect continues associated with increased fluoride
levels of about 1-1.5 ppm. It should be noticed that there is
also a direct relationship between fluoride level and the
incidence of mottled enamel. A fluoride concentration of 1
ppm was found to be optimum regards effective anticaries
effect and lower mottled enamel. In areas of communal water
supply with less than 1 ppm fluoride, the concentration of
fluoride is adjusted to reach this level. Later Fluoridation is the
most economical way for combating dental caries at the
community level.
38. It is recommended that optimal dose of fluoride ingested
daily in children from 0.5 -1.0 mg fluoride (WHO) .
So this 1 ppm fluoride concentration is suitable for countries
with cold weather whereas in countries with hot weather the
concentration of fluoride in public water supplies should be
lower and this depends on the daily water consumption
which is usually double or triple them that of cold weather .
39. 2. Fluoridation of school water
supply:
Where fluoridation of communal water supply is not possible
fluoridation of school water supply can be approached.
School children are exposed to the benefit of fluoridation
only during school days and hours.
In this case higher fluoride concentration up to 5 ppm have
been tested and proved effective in caries control.
The decrease in DMFS is about 40% with no evidence of
dental fluorosis.
40. 3. Fluoride supplements:
When fluoridation of water supply is not feasible or possible,
fluoride supplements can be resorted to. This can be in the form of
fluoride tablets, drops or syrups. Studies have shown considerable
reduction in dental caries in deciduous and permanent dentition
when consumption of fluoride has been started early enough. The
usual dose is 0.5 mg F/day for children up to 3 years of age and 1.0
mg F/day for children over 3 years of age. The fluoride tablets
usually contain 1.0 mg F, to be crushed in water or fruit juices.
Fluoride administration should continue until the age of complete
crown formation of the second permanent molar, i.e. about the age
of 10 years. Fluoride preparations should be kept out of reach of
children to avoid over dosage. Fluoride tablets disguised as sweets
are not advised.
41. 4. Fluoride incorporation in various foods:
To make fluoride administration, a personal choice,
incorporation of fluoride in certain foods of common use such
as salt, milk, bread, rice, etc, the fluoride enriched foods are
usually available on request.
It is difficult to adjust fluoride concentration to satisfy the
individual personal intake as the consumption of these foods
may vary significantly from one person to another. A careful
regulation of the prescribed daily dose and a constant
cooperation by the parents is required.
42. Topically applied fluorides:
The topical application of fluoride can be carried
out either by the patient himself or by members of
the dental profession.
44. 1. Fluoride tooth pastes (dentifrices): (Discussed before).
2. Brushing or rinsing with fluoride solution:
Studies have shown that regular rinsing or brushing (every
week or fortnight) with 0.2% sodium fluoride will reduce
dental caries incidence. The principle to be noted is the
frequent rinsing with very dilute fluoride solution. This is to
be done after the routine tooth brushing to obtain clean tooth
surface and direct access to the enamel surface.
Highly diluted solution (0.02%) can be used daily for patients
showing high caries susceptibility. Studies on supervised
month rinsig can be carried out in schools and evidence of
substantial success has been obtained.
45. 3. Fluoride gel:
This is usually commercially available product
containing 1.23% fluoride. It is widely used. The
gel has added flavours.
It has to be loaded in a special applicator to hold
the gel in place for about 4 minutes. With some
applicators, the whole mouth can be treated at
once.
46. 4. Fluoride dental floss:
Dental floss (unwaxed) impregnated with fluoride
is a valuable topical fluoride vehicle. Flossing will
result in a significant uptake of fluoride and a
reduction in the colonies of microorganisms on the
proximal tooth surfaces.
48. 1. Sodium fluoride:
The recommended procedure of 4 applications of a 2% sodium
fluoride solution, one week interval, between every
application result in an 40% reduction in dental caries
incidence.
These 4 applications are considered a single application and
have to be applied every year.
49. 2. Stannous fluoride:
Single annual application of 8% stannous fluoride gives about
65% reduction in caries incidence.
Stannous fluoride solution is unstable. It has a short shelf life,
so it has to be prepared freshly for each application by
dissolving 0.8 gm. ¬Of stannous fluoride in 10 ml distilled
water.
The solution has a disagreeable astringent taste, and it
discolors decalcified enamel.
50. 3. Acidulated phosphate fluoride:
Combination of sodium fluoride with phosphoric acid;
1.23% sodium fluoride in 0.1 M orthophosphoric acid
produces an acidulated phosphate fluoride mixture which
when applied topically to the teeth of children on an
annual basis has decreased caries from 50-70%.
This agent is stable, so it does not have to be prepared
freshly for every treatment as in cases of stannous
fluoride; also, not discolor decalcified enamel.
52. a) Stannous fluoride:
1. A thorough prophylaxis should be performed; each available
tooth surface should be cleaned and polished with pumice
and rubber cup. It is preferable to add one drop of 8%
stannous fluoride solution to the polishing paste.
2. The upper and lower teeth on one side are isolated at a time,
this is achieved with a long cotton roll in the upper and lower
buccal sulci and a short roll in the lingual area. A saliva
ejector helps to keep the area dry. The teeth are then air-
dried.
3. An 8% stannous fluoride solution is freshly prepared and
applied to all surfaces of the dried teeth with a cotton
applicator. The teeth are kept moist with the solution for 4
mm. by applying it every 15 to 30 sec .
54. c) Sodium fluoride:
1. A thorough prophylaxis is performed.
2. Teeth on one side are isolated as mentioned before.
3. Teeth are then dried and the 2% sodium fluoride solution applied
to each tooth surface including the interproximal surfaces with a
cotton applicator. The solution is allowed to dry on the teeth for 3
to 5 mm.
4. On 3 subsequent visits, usually one week apart, the same
procedure is repeated with the exception that prophylaxis is
omitted and these 4 times are considered one application. The
teeth have to be treated every year.
55. Sodium fluoride has a good shelf life; the solution can be
kept for a long period of time without deterioration. For
those children to whom it is difficult to apply fluorides every
year; it is customary to treat the teeth with topical fluorides
at 3,7,10 and 13 years of age. This is to insure that all the
primary teeth and most of the permanent ones receive the
beneficial effect of fluorides just after their eruption.
56. d) Prophylactic Paste:
The routine use of prophylactic pastes containing fluoride in
the dental office is expected to increase the fluoride content of
surface enamel and consequently, its resistance to add attack.
This will be advantageous when carried out every six months
as part of the regular dental examination.
The most recently available are stannous fluoride - zirconium
silicate paste and an acidulated phosphate fluoride - silicone
dioxide paste.